Clin Res Cardiol 100, Suppl 1, April 2011

P1351 - Incidence and Distribution of Contrast-Enhanced Infarct-Typical MRI Patterns Early and Later After Heart Transplantation
H. Steen1, E. Hofmann1, S. Lehrke1, D. Loßnitzer1, E. Giannitsis1, H. A. Katus1
1Innere Med. III, Kardiologie, Angiologie u. Pneumologie, Universitätsklinikum Heidelberg, Heidelberg;
Introduction: In heart transplant (HTX) patients (pts.), contrast enhanced cardiac magnetic resonance (CE-CMR) imaging allows myocardial tissue characterisation and identification of infarct-typical enhancement patterns which have prognostic implications for future cardiovascular events. Recently, it was shown that pts. with mild transplant coronary artery disease (TCAD) on X-ray already suffered from myocardial infarction (MI). To date there is only scarce data about the time course of myocardial infarctions in this patient collective. Therefore we sought to investigate incidence and distribution of infarct-typical CE-CMR patterns in a large patient collective of 130 pts. early and later after HTX operation.
Methods: Group 1 (68 pts.;mean =1,7ys (range=0.4-2.0ys.) after HTX) and group 2 (62 pts.; mean=5.6ys (range=2.2-15.6ys) after HTX) were scanned on a 1.5T MRI scanner (ACHIEVA, Philips,NL) with MRI contrast agent (Gadolinium:0.2mmol/kg/bw) employing an inversion-recovery multislice T1-weighted TFE sequence (TR/TE=3.0/1.1;slices=11-22;matrix=160/240, TF-factor=35;TI190-250ms). Infarct-typical CE-MRI areas were classified as sub-endocardial lesions and the location of infarction was allocated to the 17-segment model. Groups were compared using ANOVA (p-values ≤0.05=statistically significant)
Results: As can be estimated by figure 1, infarct-typical CE-MRI was already seen in 13/68 pts (29%) of group 1 (18/1156 segments) and in 20/62 pts. (32%) of group 2 (30/1054 segments;p<0.01). Interestingly, for both groups infarctions were detected predominantly in the apical regions (especially group 1) and apical to midventricular areas (group 2).
Conclusion: Even early after HTX almost 20% of pts. suffered already from MI whereas later after HTX almost one third showed infarct-typical CE-CMR. In the early phase after HTX, typical CE-MRI is by far more prevalent in apical segments that represent early infarctions of smaller and more distal coronary arteries when compared to group 2. Once the early phase is overcome, MI increasingly occurs due to long-term immuno-atherosclerotic complications like TCAD.



Clin Res Cardiol 100, Suppl 1, April 2011
Zitierung mit Vortrags- oder Posternummer s.o.
DOI 10.1007/s00392-011-1100-y